A carregar...
Publicação
Reabilitação cardiovascular em casa (REC-casa) : avaliação da qualidade de vida em pessoas com doença cardiovascular durante a pandemia COVID-19
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| 1.14 MB | Adobe PDF |
Autores
Resumo(s)
Introdução: A reabilitação cardíaca (RC) tem demonstrado, melhorar a qualidade de vida (QV) relacionada com a saúde assim como, reduzir a morbilidade futura. No entanto, a pandemia COVID-19 levou ao encerramento de muitos centros de RC. A telereabilitação (TR) usa a tecnologia de informação e comunicação para a prestação de cuidados à distância, e assim providenciar uma solução segura para os doentes, para a família e para a equipa durante a pandemia COVID-19. O objetivo deste estudo foi avaliar a QV relacionada com a saúde dos participantes que integraram o programa de RC multidisciplinar domiciliário digital “REC-casa” num período de 12 meses, durante a pandemia COVID-19.
Métodos: Foi conduzido um estudo intervencional, prospetivo, não randomizado, com uma amostra de conveniência, tendo por base a análise de 116 participantes com doença cardiovascular diagnosticada que frequentavam um programa de frequência presencial de RC de fase II ou III. Foram recrutados e avaliados (inicialmente e aos 12 meses) nos seguintes parâmetros: QV (através do questionário SF-36), atividade física (através do questionário IPAQ-SF), adesão, antropometria e controlo de fatores de risco. A intervenção consistiu num programa fase 2 e 3 multidisciplinar de RC através de canais digitais, incluindo acompanhamento regular, sessões de exercício físico, de ensino e de psicologia em grupo.
Resultados: 83 participantes (62,5 ± 8,9 anos e 81,9% sexo masculino) completaram as avaliações online nos 2 momentos propostos. Em relação à amostra total, os vários domínios da QV não sofreram alterações ao longo de 1 ano. Quando analisados os participantes com mais de 65 anos, estes também não demonstraram melhorias em nenhum domínio da QV em 12 meses. Os participantes que cumpriram as recomendações de atividade física, obtiveram valores mais elevados no Funcionamento físico (84,42±19,51 vs 72,61±25,80 p=0,026), no Papel físico (90,42±26,08 vs 67,39±40,19 p=0,001), na Vitalidade (71,75±20,00 vs 55,87±25,88 p=0,004), na Saúde mental (81,47±15,64 vs 73,57±18,83 p=0,046) e na Mudança na saúde (59,58±20,63 vs 47,83±26,02 p=0,030). Os participantes que cumpriram pelo menos 50% do programa “REC-casa”, obtiveram melhorias no Papel físico (76,70 vs 92,31, p=,022) na Mudança na saúde (50,00±21,57 vs 63,46±22,10 p=0,006).
Conclusão: Devido à pandemia, os programas de RC tiveram de encerrar tornando necessário a implementação de um programa de RC domiciliário e online. A intervenção mostrou uma manutenção da QV a um ano. Os participantes que cumpriram as recomendações de atividade física, obtiveram melhorias no Funcionamento Físico, no Papel Físico, na Vitalidade, na Saúde Mental e na Mudança na Saúde comparativamente aos participantes que não cumpriram com as recomendações. Os participantes que cumpriram pelo menos 50% do programa REC-casa, obtiveram valores mais elevados na mudança na saúde. São necessários mais programas de RC que consigam dar resposta a modelos híbridos, e com uma maior variedade de conteúdos adaptados à preferência individual de cada doente para dar resposta às suas necessidades motivacionais e clínicas.
Introduction: Cardiac rehabilitation (CR) has been shown to improve health-related quality of life (QoL) as well as reduce future morbidity. However, the COVID-19 pandemic has led to the closure of many CR centers. Telerehabilitation (TR) uses information and communication technology to provide remote care, and thus provide a safe solution for patients, family and staff during the COVID-19 pandemic. The aim of this study was to evaluate the health-related QoL in participants who integrated the multidisciplinary digital home-based CR program "REC-casa" over a 12-month period during the COVID-19 pandemic. Methods: An interventional, prospective, non-randomized study was conducted with a convenience sample, based on the analysis of 116 participants with diagnosed cardiovascular disease who attended a face-to-face CR program of phase II and III. About 88.8% had coronary artery disease (CAD), 13.8% heart failure, 59.1% hypertension and 38.3% hyperlipemia. They were recruited and evaluated (baseline and at 12 months) in the following parameters: quality of life (through the SF-36 questionnaire), physical activity (through the IPAQ-SF questionnaire), adherence, anthropometry and risk factor control. The intervention consisted of a phase II and III multidisciplinary digital CR program, including regular follow-up, exercise training, teaching and group psychology sessions. Results: 83 participants (62.5 ± 8.9 years old and 81.9% male) completed the online assessments at the 2 proposed moments. Regarding the total sample, QoL domains did not change over 1 year. When analyzing participants over 65 years of age, they also did not demonstrate improvements in any QoL domain in 12 months. Participants who followed the physical activity recommendations obtained higher values in Physical functioning (84.42±19.51 vs 72.61±25.80 p=0.026), in Physical role (90.42±26.08 vs. 67.39±40.19 p=0.001), in Vitality (71.75±20.00 vs 55.87±25.88 p=0.004), in Mental Health (81.47±15.64 vs 73.57 ±18.83 p=0.046) and Health changes (59.58±20.63 vs 47.83±26.02 p=0,030). Participants who completed at least 50% of the “REC-casa” program achieved improvements in Physical paper (76.70 vs 92.31, p=.022) and in health changes (50.00±21.57 vs 63.46±22.10 p=0.006). Conclusion: Due to the pandemic, CR programs had to close, making it necessary to implement a home-based and online CR program. The intervention showed maintenance of QoL after one year. Participants who followed the physical activity recommendations achieved improvements in Physical Functioning, Physical Role, Vitality, Mental Health and Health Changes compared to participants who did not follow the recommendations. Participants who completed at least 50% of the REC-casa program obtained higher values in Health change and Physical paper. More CR programs are needed to implement hybrid models, and with a greater variety of content adapted to each patient's individual preference to respond to their motivational and clinical needs.
Introduction: Cardiac rehabilitation (CR) has been shown to improve health-related quality of life (QoL) as well as reduce future morbidity. However, the COVID-19 pandemic has led to the closure of many CR centers. Telerehabilitation (TR) uses information and communication technology to provide remote care, and thus provide a safe solution for patients, family and staff during the COVID-19 pandemic. The aim of this study was to evaluate the health-related QoL in participants who integrated the multidisciplinary digital home-based CR program "REC-casa" over a 12-month period during the COVID-19 pandemic. Methods: An interventional, prospective, non-randomized study was conducted with a convenience sample, based on the analysis of 116 participants with diagnosed cardiovascular disease who attended a face-to-face CR program of phase II and III. About 88.8% had coronary artery disease (CAD), 13.8% heart failure, 59.1% hypertension and 38.3% hyperlipemia. They were recruited and evaluated (baseline and at 12 months) in the following parameters: quality of life (through the SF-36 questionnaire), physical activity (through the IPAQ-SF questionnaire), adherence, anthropometry and risk factor control. The intervention consisted of a phase II and III multidisciplinary digital CR program, including regular follow-up, exercise training, teaching and group psychology sessions. Results: 83 participants (62.5 ± 8.9 years old and 81.9% male) completed the online assessments at the 2 proposed moments. Regarding the total sample, QoL domains did not change over 1 year. When analyzing participants over 65 years of age, they also did not demonstrate improvements in any QoL domain in 12 months. Participants who followed the physical activity recommendations obtained higher values in Physical functioning (84.42±19.51 vs 72.61±25.80 p=0.026), in Physical role (90.42±26.08 vs. 67.39±40.19 p=0.001), in Vitality (71.75±20.00 vs 55.87±25.88 p=0.004), in Mental Health (81.47±15.64 vs 73.57 ±18.83 p=0.046) and Health changes (59.58±20.63 vs 47.83±26.02 p=0,030). Participants who completed at least 50% of the “REC-casa” program achieved improvements in Physical paper (76.70 vs 92.31, p=.022) and in health changes (50.00±21.57 vs 63.46±22.10 p=0.006). Conclusion: Due to the pandemic, CR programs had to close, making it necessary to implement a home-based and online CR program. The intervention showed maintenance of QoL after one year. Participants who followed the physical activity recommendations achieved improvements in Physical Functioning, Physical Role, Vitality, Mental Health and Health Changes compared to participants who did not follow the recommendations. Participants who completed at least 50% of the REC-casa program obtained higher values in Health change and Physical paper. More CR programs are needed to implement hybrid models, and with a greater variety of content adapted to each patient's individual preference to respond to their motivational and clinical needs.
Descrição
Tese de mestrado, Reabilitação Cardiovascular, Universidade de Lisboa, Faculdade de Medicina, 2024
Palavras-chave
Reabilitação cardíaca COVID-19 Doença cardiovascular Qualidade de vida Telereabilitação Teses de mestrado - 2024